Morbidity and Mortality
by wwheisenberg
Summary: Surgeon Edward Cullen battles his traumatic past and the demons inside himself


"X marks the spot," Edward Cullen said to himself, pushing the five-millimeter blade into the point. A textbook would call it McBurney's point, the name given to the area where the base of the appendix is commonly found, but Dr. Cullen thought it would be fair to call it the point of no return. Cutting into the point of no return was like cutting into a blood soaked sponge. Dark red oozed from the point and muddled the orange stain of disinfectant. Nearby Dr. Cullen recognized his signature, sharpied onto the patient, verifying that this was the evening's authorized appendectomy. He once harbored romantic notions about surgeons signing their patients before cutting into them; it was like an artist signing their work or a politician signing a bill into a law, but he didn't think about that anymore. Instead he thought that if the patient opened her eyes, she would see the bright light of the overhead lamp, and perhaps tried to turn away from it, thinking it the guiding light of St. Peter. Dr. Cullen, after making a fresh incision into his patient's abdominal wall, also wanted to stay out of the light. He didn't want his team to see that he was sweating.

His old colleague, Dr. Robertson, the attending anesthesiologist, must have sensed his apprehension. His calm and friendly voice offered some words of encouragement, "Starting back off with a nice easy Appy, that's the way to do it, Edward. Just like dusting off a three-wood for the first drive of spring. Speaking of which, the other day I was teeing off the back nine at Sugar Hill Country Club, and who do I see tearing down the fairway but Don Donaldson…" Dr. Cullen tuned him out; the thought of chitchat made his stomach churn. Edward felt the relief of an OR nurse blotting his forehead. When he looked up, the eyes of Bella Swan were starring back at him from behind a surgical mask. He wasn't completely surprised that she had scrubbed in tonight, but it didn't help his stomach. He glanced over at Dr. Robertson, but Robertson was still back on the Sugar Hill fairway. Well, Edward decided, it's probably hopeless to ignore her.

"Eleven blade," he said, holding out his hand.

"Eleven blade," she replied, handing him the new scalpel.

He took it and sighed, "Why are you here? Nothing else to do tonight?"

"Nothing. Thanks to you."

Thanks to me, he thought, thanks to me. The past month came rushing back, starting with the bottle of '93 Bollinger. It began as the enzymes in his saliva digested the champagne's ethanol, a byproduct of anaerobic fermentation, crucial to the life of so many Saccharomyces cerevisiae. His mind traced the events distally: his confident drive to the hospital, the attending physician in the ICU with his frantic pointing to the electrocardiograph, a lot of people throwing words around like "critical aortic stenosis" and "cardiogenic shock," eventually reaching the emergency aortic valve repair, and most proximal to his current state were things like "multiple organ failure" and "Morbidity and Mortality Conference." The memories etched themselves in the back of his retinas, as if he were examining them as slides under a brightfield microscope with the aperture too wide; they showed a colony of worrisome Gram-negative Staphylococcus, completely unrelated except for that they were in the shape of Dr. Robertson's face telling him not to worry, "I won't rat you out, you were fine in there, you were fine. Take some sick days, come back when you're ready, you're a doctor, Edward."

But Edward was most certainly not fine, and sneaking down to the morgue and staring at the toe-tag of Bella Swan didn't change that.

Edward's face began to feel warm. He recalled that night so clearly- the kick of the sternal saw on his sluggish hands as it cut through each of Bella's ribs, the blurry mess of her transected aorta, and the tingling numbness in his hands as he slipped the internal defibrillator paddles around the dead cardiac tissue that formerly composed her heart. His wife had tried to console him- she had never seen him so torn up.

"Edward, I'm sorry; it was no procedure for a general surgeon to be performing, they should have had a specialist," she tried to tell him, "a specialist." The effect of the champagne didn't even cross her mind. "There wasn't even a cardiologist present to confirm the diagnosis, Edward. The ones who didn't even show up are the ones to blame, not you."

"I think the question is- why are you here if you're so torn up about it?" It was Bella. Her mask didn't filter her foggy breath as she spoke; it had the acidic sting of alcohol. It prickled his nose, as if each one of his nasal vibrissae were being plucked. Edward blinked hard and forced himself to focus, he had a different patient right now. "I mean why are you here? Why are you even a doctor?" Edward's mind jumped to the same answer that every naïve med school interviewee gives- Bella responded before he could say it. "There are better ways to help people... Ways that aren't quite as lucrative."

Edward closed his eyes; he tried to ignore Bella and center his mind on the scalpel in his hand, but when he opened his eyes again he was cutting through an exotic fish. Its meat was soft and delicate and its outside still had scales that shimmered in the refracted light of the crystal chandelier. His wife was dressed in a lovely black dress with a beautiful corsage. His young son looked handsome in a finely tailored tuxedo, but Edward lamented that it wouldn't be long before the tuxedo was too small. Edward's daughter had an equally charming white dress. Maybe it was just seeing everyone in monochrome, but the blue of the tablecloth was particularly vivid. A team of synchronized, white glove waiters took their plates before depositing a new dish, steamed quail. The waiter placed an oversized bottled of dark red Bordeaux before Edward. "Yes, this all looks delicious, thank you! Thank you!" Edward eagerly told the waiters. He hastily motioned to pour himself some Bordeaux, but noticed that one of the three fleshy cusps forming a valve in the mouth of the bottle was defunct.

"No, no, waiter, this won't do. Take it back. This subcommisural triangle is in need of repair." He said.

"Monsieur, my regrets, I will take it away at once. How is everything else?"

"Lovely, just lovely, I…" Edward hesitated, "Well, I suppose it's a strange question, actually, but I'm really quite enamored with this tablecloth. What is it?" He massaged the thready blue cloth between his thumb and forefinger, wishing that the multitudinous plates and dishes didn't obscure it.

"Why Monsieur, it is a surgical gown of course!" the waiter replied, whisking the wine away.

How didn't he recognize it sooner? He lifted up the tablecloth and peered under it to see rotting human flesh. He shot up out of his chair. The dining table consisted of layers of clammy bodies, frozen in rigor mortis on their hands and knees. Not wanting to alarm his family he sat back down in his chair and scooted closer.

"Honey!" he whispered, "Honey, kids! Listen, we have to go, we have to go! The table is… The table is dead patients!" They ignored him.

"Honey! Kids!" he tried again, "The table! The table!"

"Edward!" said his wife, angrily slamming down her silverware to address him, "What is the big deal? So are the chairs!" He cocked his head, he wasn't sure that he heard her right. Edward felt two cold, dead hands wrap around his sockless ankles. He lurched back and turned away.

Dr. Robertson looked puzzled, an interrupted golf story still hanging on his tongue. Edward cleared his throat, "…Uh…Almost sneezed. I'm alright." Bella said "You're in it for the money. You didn't care about helping me. You're a liar, Edward." Edward's face felt numb. He hadn't had anything to drink since the incident, but the more he examined his own physiology, the less he sensed sobriety.

"Sure you're alright, Edward?" Robertson's voice did nothing to reassure him. Edward tensely cleared his throat.

"Yeah," he said.

Bella's eyes gave away her frown, "No it's not, you're drunk again."

Dr. Cullen considered her words, and blinked furiously; there wasn't much else he could do to try to awaken himself from this dream. He hadn't had anything to drink; it wasn't possible. "Well, you're talking to a ghost, aren't you? Have you ever done that sober?" Edward's vision blurred. He was at the caecum, all he had to do was sever the appendix, or was it repair an aortic valve? "It's okay Edward, you've been here before. Don't let a little liquor stop you." To cut or not to cut? He could ask Robertson, but Robertson was trying to figure out whose ball he hit off the last tee, because Don Donaldson also happened to be hitting a Titlist 5, if you can believe that.

Looking back down to his work, Edward tied off the caecum where he had just severed it from the removed appendix. He blinked more, realizing what he'd just done. The appendix had been removed. All he had to do now was stitch this girl back together. All he had to do was close. Edward's panic returned when he noticed that the effects were getting stronger. Champagne bubbles fizzled in his brain. They popped against his temporal lobe and released the laughter of Bella's children. Their soft voices were somewhere back in time, playing in an apple orchard next to their family's hill house in the country-side at sundown. And as the sun began to set, the hills turned purple and deep fissures formed. The children ran across the folds in Edward's neural tissue, lost in the dark- frantic and calling for their mother. The soles of their sneakers treaded heavier and heavier on his brain with each step. He was trying to suture, but his double vision returned. Were there two caecums that needed sewing? He tried to sew them both, but he put a suture through something he shouldn't have. His gaze shot up to meet Dr. Robertson's. Robertson had seen it. Robertson glared. Dr. Cullen thought he might throw up in the patient's abdominal cavity, but then she would definitely become septic.

"Oops." Dr. Cullen said to the staff. "I hit a rough spot on… on, uh… the transversus. Just going to repair the damage and continue." He hiccupped. Upon looking down he noticed some blood that didn't belong there; it obscured the surgical field. He wanted to ask for suction, but didn't want to open his mouth again, because he could feel it watering. Dr. Cullen hesitantly looked back up to see Dr. Robertson still staring intently. He looked back down.

"It's fine, we're all fine here, just go back to your story." Dr. Cullen breathed. His eyes were watering; he wanted to wipe them; he also wanted to wipe his lips, they felt wet. Instead he began to gnaw his lip.

"I'm sorry, Edward?"

Cullen closed his eyes hard and tried to focus, he wanted to focus, why couldn't he focus? Why couldn't he let go? He looked back up at Robertson. He was paging somebody. And because nobody else seemed to care about the girl with the hot appendix, the monitor issued its warning: a gentle blip, blip, blip.

Inside Dr. Edward Cullen's head the blip, blip, blip grew louder and curtains opened. The four sugarplums of ethics commenced their recital. "Justice" pirouetted to center stage, her off-axis wobble the tell-tale sign of end stage inebriation. Dr. Cullen had never seen such a sloppy performance, and he winced at every revolution, expecting her ankle to buckle or snap cleanly in half. "Autonomy," possibly more intoxicated than Justice, could only manage to stagger back and forth in an arrhythmic adagio, her zombie's gaze fixed on Dr. Cullen. He slouched in his chair to hide from it, but he was alone in the dark audience. "Benificence" was in a tachycardia-esqe chasse. She leapt faster, and faster around the circumference of his brain. "Stop!" he yelled, now slumped to the sticky auditorium floor- apparently the last guests had spilled something, some sort of soda? Nope, he smelled it, '93 Bollinger, a pity to spill such nice champagne. The sugarplums must have agreed, as their dance became faster and dizzier. His brain felt like it was being spun in a high-powered centrifuge. "Stop. Please stop." He weakly breathed. The blip, blip, blip now accompanied a full orchestra. The music began to crescendo. He looked up to yell when there was a great crash of cymbals and voices- he looked just in time to see the grand finale! He was just in time to see "Nonmaleficence," "primum non nocere," and as she's sometimes called "first, do no harm" swan dive from the rafters with a noose tied firmly around her little neck.

"NO!" He yelled. He shut his eyes as tightly as he could.

Dr. Cullen bit hard and lacerated his Labium inferius. The receptors in his tongue's epithelium detected the sour, savory elements of blood. He handed the suture to his assisting nurse, Bella nowhere to be seen. His nasolacrimal ducts began to secrete tears, which his tongue's epithelium incorrectly concluded to be saline solution as they dripped down his bony zygomatic arch. His ability to balance now significantly deteriorated, he staggered a step back and then allowed the spinning room's centrifugal force to push him into the OR's corner. Footsteps of other doctors made their way through his external auditory canal, through his tympanic cavity, resonated off his tympanic membrane and cochlea and eventually arrived, to save the day.

He heard the hollow voice of his old friend Doctor Robertson; it resonated off the blue tile, off the surgical light, off the monitors and tools, off everything in the operating room. The hollow voice filled his hollow head.

"On your first surgery back? What in God's name were you thinking?"

Edward asked, "Well…I… I didn't…Did I kill her?"


End file.
